The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment
Reza Salman Roghani,1,2 Seyed Ebrahim Hashemi,2 Mohammad Taghi Holisaz,2 Faeze Gohari,3 Ahmad Delbari,4 Johan Lokk1 1Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden; 2Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of M...
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Dove Medical Press
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oai:doaj.org-article:3652a07b26fb419abe19414e3cde9eab2021-12-02T08:32:31ZThe diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment1178-1998https://doaj.org/article/3652a07b26fb419abe19414e3cde9eab2018-10-01T00:00:00Zhttps://www.dovepress.com/the-diagnostic-accuracy-of-median-nerve-ultrasonography-in-elderly-pat-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Reza Salman Roghani,1,2 Seyed Ebrahim Hashemi,2 Mohammad Taghi Holisaz,2 Faeze Gohari,3 Ahmad Delbari,4 Johan Lokk1 1Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden; 2Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran; 4Iranian Research Center on Aging, University of Social Welfare and Rehabilitation, Tehran, Iran Background: Accurate diagnosis of carpal tunnel syndrome (CTS), the most common entrapment neuropathy, and its differentiation from other diseases are essential, especially in older individuals with advanced symptoms and modified electrophysiological abnormalities. The current study was conducted to evaluate the diagnostic accuracy of ultrasonography (US), regarding sensitivity and specificity in the diagnosis of CTS in elderly patients. Methods: Individuals with upper limb complaints and reference subjects were recruited from the Rofaydeh Hospital, Tehran, Iran, from June 2013 to October 2014 – (15 months). We evaluate case and control subjects for health status, demographics, clinical characteristics of CTS, median nerve physiology by electrodiagnostic tests, and anatomy by US. Median nerve cross-sectional area (CSA) at precanal, tunnel inlet, midcanal, tunnel outlet, and antecubital levels was measured applying US examination. Results: Of the 723 complaining patients, we assessed 380 patients with CTS symptoms. Electrodiagnostic studies (EDX) confirmed the CTS diagnosis in 203 of these clinically diseased patients. A total of 103 patients (of the 113 reference subjects) had normal EDX in the reference group. Comparisons of wrists between the afflicted and reference subjects demonstrated the CSA at precanal, tunnel inlet, midcanal, and tunnel outlet levels being significantly more abundant in the diseased hands than in the nondiseased hands. CSA at the tunnel inlet and the inlet-to-antecubital CSA ratio with a threshold of 8.5 mm2 and 0.65 gave the best diagnostic accuracy with a sensitivity and specificity of 96.9 and 93.6% for the inlet CSA and 99 and 28% for the CSA ratio, respectively. Conclusion: The US as a noninvasive diagnostic method may serve for the investigation of CTS in elderly patients with excellent sensitivity and specificity. Keywords: carpal tunnel syndrome, ultrasonography, electrophysiology, sensitivity, specificitySalman Roghani RHashemi SEHolisaz MTGohari FDelbari ALokk JDove Medical PressarticleCarpal Tunnel SyndromeUltrasonographyElectrophysiologySensitivityand Specificity GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 1953-1962 (2018) |
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Carpal Tunnel Syndrome Ultrasonography Electrophysiology Sensitivity and Specificity Geriatrics RC952-954.6 |
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Carpal Tunnel Syndrome Ultrasonography Electrophysiology Sensitivity and Specificity Geriatrics RC952-954.6 Salman Roghani R Hashemi SE Holisaz MT Gohari F Delbari A Lokk J The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment |
| description |
Reza Salman Roghani,1,2 Seyed Ebrahim Hashemi,2 Mohammad Taghi Holisaz,2 Faeze Gohari,3 Ahmad Delbari,4 Johan Lokk1 1Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden; 2Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran; 4Iranian Research Center on Aging, University of Social Welfare and Rehabilitation, Tehran, Iran Background: Accurate diagnosis of carpal tunnel syndrome (CTS), the most common entrapment neuropathy, and its differentiation from other diseases are essential, especially in older individuals with advanced symptoms and modified electrophysiological abnormalities. The current study was conducted to evaluate the diagnostic accuracy of ultrasonography (US), regarding sensitivity and specificity in the diagnosis of CTS in elderly patients. Methods: Individuals with upper limb complaints and reference subjects were recruited from the Rofaydeh Hospital, Tehran, Iran, from June 2013 to October 2014 – (15 months). We evaluate case and control subjects for health status, demographics, clinical characteristics of CTS, median nerve physiology by electrodiagnostic tests, and anatomy by US. Median nerve cross-sectional area (CSA) at precanal, tunnel inlet, midcanal, tunnel outlet, and antecubital levels was measured applying US examination. Results: Of the 723 complaining patients, we assessed 380 patients with CTS symptoms. Electrodiagnostic studies (EDX) confirmed the CTS diagnosis in 203 of these clinically diseased patients. A total of 103 patients (of the 113 reference subjects) had normal EDX in the reference group. Comparisons of wrists between the afflicted and reference subjects demonstrated the CSA at precanal, tunnel inlet, midcanal, and tunnel outlet levels being significantly more abundant in the diseased hands than in the nondiseased hands. CSA at the tunnel inlet and the inlet-to-antecubital CSA ratio with a threshold of 8.5 mm2 and 0.65 gave the best diagnostic accuracy with a sensitivity and specificity of 96.9 and 93.6% for the inlet CSA and 99 and 28% for the CSA ratio, respectively. Conclusion: The US as a noninvasive diagnostic method may serve for the investigation of CTS in elderly patients with excellent sensitivity and specificity. Keywords: carpal tunnel syndrome, ultrasonography, electrophysiology, sensitivity, specificity |
| format |
article |
| author |
Salman Roghani R Hashemi SE Holisaz MT Gohari F Delbari A Lokk J |
| author_facet |
Salman Roghani R Hashemi SE Holisaz MT Gohari F Delbari A Lokk J |
| author_sort |
Salman Roghani R |
| title |
The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment |
| title_short |
The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment |
| title_full |
The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment |
| title_fullStr |
The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment |
| title_full_unstemmed |
The diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment |
| title_sort |
diagnostic accuracy of median nerve ultrasonography in elderly patients with carpal tunnel syndrome: sensitivity and specificity assessment |
| publisher |
Dove Medical Press |
| publishDate |
2018 |
| url |
https://doaj.org/article/3652a07b26fb419abe19414e3cde9eab |
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